Gangrene

Gangrene is complication of necrosis characterised by the decay of body tissues. Results from ischaemia, infection, or trauma (or a combination of these processes).

Two main categories: infectious gangrene (which includes necrotising fasciitis and gas gangrene) and ischaemic gangrene (which can arise from arterial or venous obstruction).

Risk factors include diabetes, smoking, atherosclerosis, renal disease, drug and alcohol abuse, malignancy, trauma or abdominal surgery, contaminated wounds, malnutrition, hypercoagulable states, prolonged use of tourniquets, and community-acquired MRSA.

Successful treatment of infectious gangrene requires early recognition and a combination of aggressive surgical debridement, appropriate intravenous antibiotics, and intensive supportive care.

Ischaemic gangrene requires revascularisation for obstruction and thromboembolism, along with optimal treatment of any underlying disease. Measures to prevent superimposed infection must also be performed.

Prognosis is highly variable, but can involve significant morbidity and mortality.

Gangrene is a complication of necrosis characterised by the decay of body tissues. There are two major categories: infectious gangrene (wet gangrene) and ischaemic gangrene (dry gangrene). The condition may result from ischaemia, infection, or trauma (or a combination of these processes). Ischaemia may result from either arterial or venous compromise, and may be an acute or chronic process (or a combination of both). Critically insufficient blood supply is the most common cause of gangrene, and is often associated with diabetes and long-term smoking.[1]Mandell GL, Bennett JE, Dolin R. Principles and practice of infectious diseases. 6th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2005.